WILEY SMART MCCREEDY (NPI# 1134601180) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134601180 |
| Entity Type | Individual |
| Full Name | WILEY SMART MCCREEDY |
| Credential | PA |
| Practice Address |
19250 Sw 65th Ave Ste 260 Tualatin OR 97062-7747 |
| Mailing Address |
2112 Nw Quimby St Apt 542 Portland OR 97210-2380 |
| Practice Telephone | 1503885884 |
| Practice Fax Number | 5038858946 |
| Mailing Telephone | 9707290488 |
| Enumeration Date | 2018-09-05 |
| Last Update Date | 2018-09-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
19250 SW 65TH AVE STE 260 |
| City | TUALATIN |
| State | OR |
| Zip Code | 97062-7747 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467018739 | Activeedge Tualatin, LLP | Physical Therapist | 19150 Sw 90th Avenue, Suite 200, West Linn, OR 97062 | 2019-05-13 |
| 1932607934 | Naturalways Pediatrics | Clinic/Center | 18813 Sw Martiazzi Ave, Tualatin, OR 97062 | 2018-01-25 |
| 1831646280 | Elizabeth Erin Tafesse | Behavioral Analyst | 18765 Sw Boones Ferry Rd Suite 100, Tualatin, OR 97062 | 2016-09-01 |
| 1962851311 | Ana Mercedes Cerritos-sanchez | Community Health Worker | 19355 Sw 65th Ave Apt A5, Tualatin, OR 97062 | 2016-06-07 |
| 1952759318 | William Luke Summers | Counselor | 18840 Southwest Boones Ferry Rd, Suite 208, Tualatin, OR 97062 | 2016-05-26 |
| 1730536913 | Krystle Alligood | Behavioral Analyst | 18768 Sw Boones Ferry Road, Tualatin, OR 97062 | 2016-05-18 |
| 1760869739 | Oregon City Medical Nw, Inc | Clinic/Center | 6464 Sw Borland Road #d-4, Tualatin, OR 97062 | 2015-04-29 |
| 1396148904 | Tracy Filley | Clinical Nurse Specialist | 18840 Sw Boones Ferry Rd, Suite 208, Tualatin, OR 97062 | 2014-09-28 |
| 1043646474 | Michelle Lords | Registered Nurse | 7668 Sw Mohawk Street, Tualatin, OR 97062 | 2013-09-17 |
| 1871930750 | Sharon Ruth Frank | Social Worker | 7668 Sw Mohawk St., Aps Healthcare, Tualatin, OR 97062 | 2013-05-31 |
| Find all providers in zip 97062 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023249810 | Holly Walkington-brock | Physician Assistant | 19260 Sw 65th Ave Ste 275, Tualatin, OR 97062-5708 | 2009-07-28 |
| 1356506943 | Zachary James Knight | Physician Assistant | 19255 Sw 65th Ave Ste 200, Tualatin, OR 97062-9712 | 2008-07-23 |
| 1194343640 | Emily Ann Geyen | Physician Assistant | 19260 Sw 65th Ave Ste 270, Tualatin, OR 97062-5705 | 2020-07-10 |
| 1467076539 | Andrea Taylor Ball | Physician Assistant | 19250 Sw 65th Ave Ste 365, Tualatin, OR 97062-7747 | 2020-06-03 |
| 1194356915 | Tyler Garrett Huntington | Physician Assistant | 6464 Sw Borland Rd Ste A2, Tualatin, OR 97062-8854 | 2020-01-30 |
| 1619445715 | Kelsey Lynn Gretzinger | Physician Assistant | 19255 Sw 65th Ave Ste 200, Tualatin, OR 97062-9712 | 2018-11-06 |
| 1710497185 | Gabriel Joseph Francetich | Physician Assistant | 19250 Sw 90th Ave, Tualatin, OR 97062-7585 | 2017-10-11 |
| 1346639440 | Donald Mccorkel | Physician Assistant | 19250 Sw 65th Ave, Suite 265, Tualatin, OR 97062 | 2015-01-13 |
| 1295138048 | Heather L Marsh | Physician Assistant | 6464 Sw Borland Rd Ste A2, Tualatin, OR 97062-8854 | 2014-10-07 |
| 1124454939 | Nicole Celeste Foster | Physician Assistant | 19260 Sw 65th Ave Ste 280, Tualatin, OR 97062 | 2013-09-25 |
| Find all providers in TUALATIN | ||||
Please comment or provide details below to improve the information on WILEY SMART MCCREEDY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.